This study was conducted from 1998 to 2001. The purpose of this study was to test the validity of the "integrated Approach to Symptom Management" (IASM) model of symptom management. This model was originally developed as "MSM"(Model for Symptom Management) by the UCSF faculty group to deal with the various symptoms of cancer patients, and then modified as the IASM by Larson, Uchinuno, (1998) for clinical application. In 1998, the researchers developed a guidebook that covers an integrated approach to symptom management and nursing records for clinical application. The tools needed to measure the validity of the model and a method of analysis were also determined. In 1999, the researchers and clinical nurses who collaborated in this study applied the integrated approach to the symptom management of 15 ancer patients in an attempt to relieve their cancer related symptoms, including pain, nausea, vomiting, dyspnea, and fatigue. It was found that in most cases, the patients become better a
… Moreble to care for themselves, and as a result experienced some degree of relief from their cancer-related symptoms. However, it was also found that patients at the end stages of cancer had difficulty in improving their capacity for self care, which therefore made it difficult to achieve relief from their physical symptoms. In 2000, in order to validate the applicability of the model, the research team focused on patients with a performance status of 1-2. It was found that the effects of IASM were realized more easily for such patients, and that IASM was effective in improving the patients capacity for self care, and therefore, in relieving cancer-related symptoms.The purpose for the final year of the study was to examine the effectiveness of IASM introduction to an entire hospital ward. The research team introduced the model to a hospital ward, and all of the nurses agreed to utilize the model and apply it to their patient care. The process of the introduction of the model was recorded and analyzed using the Theory of Change. The nurses who used this model found that it resulted in changes in the way they handled the symptom care of their patients. We found that it is important to apply the theory of change carefully when introducing a project to an organization.Overall, this study has clarified the following : 1) IASM is a valid method for providing the patient with relief from symptoms. 2) IASM can be introduced into an entire hospital ward or unit simultaneously. 3) This model can also be used with the developed guidebook.1998年度から2001年度にかけて、個別事例へのIASMの適用から,IASM看護活動が患者の症状緩和に有効であることが示された。また、IASM看護活動を個々の看護師が使用できるまでの洗練を行い、このモデルの病棟組織への導入までの実用化の段階まで進めることができた。 Less